Author reply to “When episiotomy is counted as injury: refining perineal outcomes in women with IBD”
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ID: 318188
2026
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Abstract
Dear editors, We thank Li and Gu for their thoughtful comments regarding our recent study1 and for the opportunity to further clarify the interpretation of perineal outcomes in women with inflammatory bowel disease (IBD). We appreciate their important distinction between spontaneous perineal trauma and episiotomy, which represent conceptually different obstetric outcomes. In the original study, we used a composite definition of overall perineal injury that included spontaneous perineal tears, labial lacerations, obstetric anal sphincter injury (OASI), and episiotomy, aiming to capture the full spectrum of clinically relevant perineal morbidity and obstetric interventions during vaginal birth. We agree, however, that episiotomy may additionally reflect obstetric decision-making rather than intrinsic tissue vulnerability. Importantly, even in the original analysis, women with and without IBD did not significantly differ in rates of spontaneous perineal tears (50.0% vs 54.1%, P = 0.197), labial tears (7.4% vs 9.7%, P = 0.214), episiotomy (40.6% vs 36.5%, P = 0.185), or OASI (0.4% vs 0.9%, P = 0.728).
| Reference Key |
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|---|---|
| Authors | Itamar Gilboa, Daniel Gabbai, Noy Segal, Ronen Gold, Asnat Groutz, Avital Skornick Rapaport, Yariv Yogev, Y Baruch |
| Journal | inflammatory bowel diseases |
| Year | 2026 |
| DOI |
10.1093/ibd/izag110
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| URL | |
| Keywords | Keywords not found |
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